Psychological aspects of Psoriasis

Psoriasis is a chronic, relapsing and usually lifelong condition. Patients with psoriasis often lose hope that their condition can be managed. This may lead to poor treatment compliance. It is a well established fact that in addition to physical discomfort and disability, psoriasis can produce anxiety, depression and other psychological problems, which in turn can aggravate the disease.

A number of studies have shown that psychological stress is often caused by psoriasis, and can be a factor in flare-ups of psoriasis. Pruritis in psoriasis contributes to stress and the stress in turn can lead to more pruritis. This vicious cycle can contribute to psychological problems including depression, anxiety, aggressive behaviors, obsessional behavior, and alcoholism.The other psychological problems can include poor self-esteem, sexual dysfunction, and suicidal ideation. The mechanisms by which psychological stress can make pruritis worse are not clearly understood.

Psychological counseling may be helpful in some patients with psychosocial problems. A family counseling session may also help the family members to understand the nature of the disease better and realize the role that family members can play in reducing psychosocial stress.

Traditional psoriasis treatment regimens may be augmented with stress-reduction strategies. Biofeedback training, psychotherapy, and hypnosis are examples of adjuncts to traditional medical treatment.

Hypnosis may improve or resolve numerous dermatoses, including psoriasis. In addition, hypnosis can facilitate aversive therapy and enhance desensitization and other cognitive-behavioural methods.

Cognitive behaviour therapy combines two kinds of psychotherapy, cognitive therapy and behaviour therapy. CBT has been very thoroughly researched. Numerous studies have shown CBT to be as effective as drugs in treating both depression and anxiety.

Recognising eating disorsers

I had a friend who was a food enthusiast. She loved to visit all kinds of exotic restaurants and try new flavors. She always used to stay slim though and I was really amazed how she managed to maintain her figure. Over the years, she became too thin and looked tired and withdrawn. Imagine my surprise when I discovered that she was a bulimic.

It is too lengthy to go into the specifics of each eating disorder but I would like to point out some salient features on how to recognize the common signs of eating disorders: excessive and sudden preoccupation with body image and thinness, excessive exercising, fine hair on arms and face with loss of scalp hair, irregular or lack of periods in girls, dry skin with desquamation etc. Bulimics have some dental signs like caries, and gum disorders. Russell's sign is bleeding, scarred, or callused knuckles (due to repeated contact with the front teeth). The person may lie about food intake, conceal food or buy laxatives diuretics etc.

Of course, in some cases, there may be very subtle signs that even an observant parent or friend cannot pick up, and oh, don't forget that eating disorders are not uncommon in males too.

Related links:
Bariatric surgery

Attention Deficit Hyperactivity Disorder (ADHD)

It is really sad when teachers and parents label kids "stupid" without knowing that there might be an underlying disorder, like ADHD. Attention Deficit Hyperactivity Disorder (ADHD) is a disorder manifested in preschool and early school children who often have difficulty in controlling their behavior and/or pay attention. The exact etiology of this condition is unknown but it is thought to be a genetic disorder, with deficient dopaminergic neurotransmission.
The symptoms of ADHD include: inattention, hyperactivity, and impulsivity. The condition is usually suspected when such symptoms starts to affect the child’s school performance, or behavior at home. More often, the condition may not be detected till a considerable time has passed. The child may demonstrate symptoms like constant fidgeting,restlessness, squirming etc.
Medications like amphetamine, dextroamphetamine, methylphenidate and pemoline are used. Interventional approaches like psychotherapy, behavioral therapy, social skills training etc may also be helpful.